5 Methotrexate Myths That Are Scaring Patients (Truth Revealed)

Introduction to Methotrexate Myths 0:00

You have been prescribed methotrexate so you google it and now you are terrified. Chemotherapy drug, liver damage and destroys your immune system and causes cancer. Sound familiar to you? What if I told you that most of what you have read online is either exaggerated taken out of context or flat out wrong. I'm a rheumatologist and today I am busting five biggest myths about methotrexate side effects. The myths that scare a lot of you from this medication that could save your joints and possibly extend your life.

Before I go further, Have you ever been scared to take methotrexate because of something you have read online? Drop yes or no in the comments below. I want to know what you've been told. Before we bust these wide open, here is the roadmap of the 5 myths that we are talking today. Myth number 1. It's a chemotherapy drug. So the side effects must be terrible. Number 2. it will destroy your liver. It will wreck your immune system.

Myth 1: Methotrexate Is Just Chemotherapy 1:14

Everyone will get sick on methotrexate. And the most scariest one of all, it causes cancer. So let's start with the myth number one. It is a chemotherapy drug, so the side effect must be terrible. Metatrixid, when it was first discovered, it developed as a chemo therapy drug in the 1940s. But when you Google, the internet leaves out the most important detail. The dose that makes all the difference. For cancer chemotherapy patients receive hundreds of even thousands of milligrams multiple times a week.

Your dose for rheumatoid arthritis is 7.5 milligram to 25 milligram just once a weak. You see the difference. If you do the math that is up to 100 times less medication than as a chemotherapy. Think of it like a water. water can power a fire hose that knocks down the building, or a guarding sprinkler that gently water your flowers. It is exactly the same substance, but the completely different effect. A big study of almost 7,000 patients found that low-dose methotrexate did not increase the risk of serious adverse event or death compared to people who are not taking metotrexxate.

and only about 5 to 7 percent of the patients had major side effects. That means almost more than 90 percent the patient did tolerate the medication well. At rheumatoid arthritis doses, methotrexid is a completely different medication than as a cancer chemotherapy.

Myth 2: It Will Destroy Your Liver 2:56

Now the myth number two, it will destroy your liver. Yes, Methotrexate can affect your liver. But here is what the scary article leaves out. For about 15% of the patients, there is a mild temporary elevation in the liver enzymes. This usually normalizes on its own or simple dose adjustment. It does not mean liver damage. persistent elevation, needing a dose reduction are uncommon, and a significant fibrosis is very rare. A 2023 study in the Journal of Hepatology studied nearly 1,000 patients on long-term methotrexate.

And their conclusion? The risk of liver fibroids has been vastly overestimated. Neither the cumulative dose nor the duration of methotrexate was associated with elevation of liver stiffness. The real risk factor were different, and they were diabetes, obesity or extra weight, high BMI, not the metho trexite itself. So those other medical conditions were contributing to a risk of cirrhosis, Not just the Metho Trexit. Your rheumatologist monitors those liver marker very regularly. These cast problem early before they cause problems.

Now, the myth number three, it wrecks your immune system. It wipes out your system now. This particular myth got super charged during the covid-19 infection. But let's set the record straight. Methotrexate does not destroy your human system, It regulates your own system Think of it like a thermostat.

Myth 3: It Wrecks Your Immune System 4:38

In rheumatoid arthritis, your immune system is turned up too high, attacking your own joints. Metatrixid, turn it down to the normal level. It does not shut it off. When we look at the bigger studies, there were 12 randomized controlled trials found that metatixid caused a small increase in common infections, like colds or bronchitis. but no major increased risk of serious infection. When you compare the methotrexate with the prednisone, which is a commonly used drug, the overall risk is much higher with prednison compared to methtrexxate.

That's why your methetrexit is even safer medication than the prediction you might be taking for rheumatoid arthritis. Now the myth number four. Everyone gets sick on it. Rheumatoid arthritis forums are full of horror stories about methotrexid nausea. But here is what the forums don't show. The majority of the patients who do just fine. They don' post because they have nothing dramatic to report. When we look at bigger studies, there was one particular study that looked at 20,000 patients. they found that 76% of patients do not get nauseous.

80% have no stomach pain. Only 8.5% stop methotrexid because of these gastrointestinal side effects. And if you do feel sick, the side-effects are fixable.

Myth 4: Everyone Gets Sick on Methotrexate 6:07

By taking your folic acid daily, it reduces the gastointenital side effect by 26%. Take your dose at bedtime so you sleep through the worst of it. Switch to the injection form of methotrexate, which can minimize this further. You can also split the dose or take it with your light meal. Those are the things that can minimise the nausea if you have. Research shows that patients who read scary information before taking a metho trexite are more likely to experience the side effects and can actually create them.

So take a deep breath if your doctor prescribed you methtrexxate. the science says most people do very well so be careful of what you are reading in the internet that might be giving you the nausea methotrexate not the medication itself now the myth number five the last myth and that is it causes cancer and this is the one that causes the most panic for our patients. Let me address it with complete honesty. There is a weak association of metatrixid with some blood cancers. A study of almost one thousand R.A.

patients found that the incidence was about one point three percent to five percent per year. And in many cases, these condition reverses on its own when metotrix was stopped. There is also a slightly increased risk of skin cancer, so use your sunscreen and also have a regular yearly follow-up with your dermatologist to look for any cancer while you are taking methotrexate. Now let's also look at the bigger picture. Uncontrolled rheumatoid arthritis itself increases your risk for lymphoma by 2 to 3 times.

So the real question is not, does methotrexate increase cancer? It is.

Myth 5: Methotrexate Causes Cancer 7:58

What happens if I don't treat your rheumatoid arthritis? Untreated rheuma arthritis leads to joint destruction, disability, increased cardiovascular disease, and a shortened lifespan. the benefit of treatment far outweighs the small manageable risk that could come with methotrexate. Now let me summarize those five important myths that we busted today. Number one, it is a chemo drug that is busted. Your dose is up to 100 times lower and over 90 percent patients do tolerate it. It destroys your liver.

That is also busted. The risk is overestimated and only three to seven percent of the patients stop methotrexid because of liver problem. And the myth number three, it wrecks your immune system. It regulates your system, does not destroy it. Number four, Everyone gets sick on methotrexate that is also busted. 76% of the patients don't get any nausea and the side effects are manageable and fixable. And the number five, the most scariest one, it causes cancer. That was also busted. The overall risk of cancer is quite low with methotrexate.

Now I have created this checklist, your myth-busting checklist. So take a screenshot. And when you go see your rheumatologist, if they prescribe you methtrexit, you can go over those myths. Don't let the chemo label scare you. Take your folic acid every day. Keep up with your blood testing as your doctor suggested.

Key Takeaways and Safety Checklist 9:39

That is your safety net. If you feel nauseous, use the fixer that we have discussed. Bedtime dosing, taking with food, splitting the dose, and injections. Get your vaccines, including flu and the pneumonia vaccine. use sunscreen to protect your skin and report any unusual symptoms to your doctors and always remember untreated rheumatoid arthritis is far more dangerous than methotrex itself and I agree with many of my patients Metatrixid is not perfect. No medication is. But it is the most studied, most trusted, and most effective first-line medication for rheumatoid arthritis.

It has been used safely for over 50 years. The myths that scare my patients away from it cause far more harm than the medication itself. Uncontrolled RA destroys your joints, damages your heart, and could shorten your lifespan. Don't let misinformation rob you from a medication that could transform your rheumatoid arthritis life. Let me leave you with a question. Which myth surprised you the most? Drop it in the comment below. And if this video changed how you feel about methotrexate, share it with someone who needs the truth.

Now, the next week, we are coming up with five important truths about methotrexxate. So tune in to our channel. I'll see you next week. Bye bye.